BBP/PPE TRAINING Division of Public Health. Bloodborne Pathogens Viruses, bacteria and other microorganisms that: Are carried in the bloodstream or transmitted.

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Presentation on theme: "BBP/PPE TRAINING Division of Public Health. Bloodborne Pathogens Viruses, bacteria and other microorganisms that: Are carried in the bloodstream or transmitted."— Presentation transcript:

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BBP/PPE TRAINING Division of Public Health

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Bloodborne Pathogens Viruses, bacteria and other microorganisms that: Are carried in the bloodstream or transmitted by Other Potentially Infectious Materials (OPIM) Cause disease There are over 20 different bloodborne pathogens

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OSHA’S BLOODBORNE PATHOGENS STANDARD The purpose of OSHA’S Bloodborne Pathogens Standard is to reduce occupational exposure to Hepatitis B, Hepatitis C, HIV and other bloodborne pathogens that employees may encounter in their work place.

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WHO is Covered by the Standard? All employees who could be “reasonably anticipated” to face contact with blood or other potentially infectious materials as the result of job duties “Good Samaritan” acts such as assisting a co-worker with a nosebleed would not be considered occupational exposure

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Exposure Control Plan OSHA Requirement OSHA – the Occupational Health and Safety Administration requires employers to develop an Exposure Control Plan. This plan provides protection for all health care workers who might be exposed to bloodborne diseases. The plan outlines the steps employers must take to provide protection against bloodborne pathogens.

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HIV virus that causes AIDS WI prevalence: 9,500 cases of AIDS/HIV incubation period 1 to 3 months person is infectious from onset of infection throughout life all persons are susceptible Symptoms in acute stage include fever, rapid weight loss, night sweats, pneumonia

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Risk Factors for Acquiring HIV Infection in Health Care Sustaining a deep injury Sustaining an injury with a device which is visibly contaminated with blood Being injured with a needle which had been placed directly into the source patient’s artery or vein Source patient is in terminal stages of AIDS

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Standard Precautions used on ALL individuals used for ALL contact with: blood, all body fluids (except sweat) mucous membranes non-intact skin If it’s wet and it comes from the human body—treat as infectious!

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more effective against organisms convenient takes less time than soap and water wash gentler to skin than soap, water, paper towels may use if hands are not visibly soiled Hand Hygiene Alcohol hand gel is preferred method in health care settings

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Hand Hygiene Use of alcohol gel press pump down completely to dispense appropriate amount dispense into palm of one hand rub palms, backs of hands, fingers, fingertips, nails, in between fingers until dry, about 30 seconds make sure hands are dry before resuming activities

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PPE - Gowns Gowns are used to protect clothing Needed to prevent penetration of blood or OPIM If the only anticipated splatter is a dot of blood, a cloth gown or lab coat is satisfactory If it’s anticipated that the splatter could penetrate to the skin, an impervious gown, or plastic apron is needed

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PPE - Resuscitation devices Resuscitation Devices Know where these devices are kept Use pocket masks whenever performing CPR Use pocket masks whenever performing CPR – they must have a filter and mouth piece Must be cleaned after each use A new one-way valve must be placed after each use

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Removal of PPE after use 1) Remove gloves by grasping outside of one glove with other gloved hand and peel off. Hold removed glove in gloved hand. 2) Slide fingers of ungloved hand under remaining glove to remove. Discard both gloves. 3) Remove any PPE from face next, handling by head bands, ear pieces, or ties. Discard. 4) Remove gown by pulling away from neck and shoulders, touching ties only. Pull arms out of sleeves, turning the gown inside out and away from body. Discard.

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Medical Waste Cont. Never: Mix Medical Waste with General Waste! Mix Medical Waste with General Waste! OR OR Place your hand in a red bag or sharps container to retrieve an item! Place your hand in a red bag or sharps container to retrieve an item!

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Cleaning/disinfection Cleaning must be done before disinfection can occur Disinfectant must remain on item or surface for specified contact time

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Laundry place dry laundry in bags at point of use handle with minimal agitation laundry that is wet from blood or OPIM is placed in plastic bags send to professional cleaners lab coats personal clothing visibly soiled with blood or OPIM

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Safe injection practices Use aseptic technique Do not use same syringe for multiple patients, even if needle is changed Use single dose vials whenever possible If multi dose vials are used, needles, cannulas, syringes used to access vials must be sterile

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Engineering Controls Safety Devices Sharps Containers

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Safety Devices Where a safety device exists, you must use it Primary defense against bloodborne pathogens Do not tamper or alter Do not activate safety device by hand, use hard surface to activate Dispose of in sharps container Report device failure to infection control epidemiologist

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Sharps Containers Wall mounted/countertop/portable Must be: Red or biohazard labeled Kept covered at all times Stable - unable to tip over Replaced when 2/3 full Have secure lid for disposal Disposed of at SLH

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Work Practice Controls Do not eat, drink, apply make-up, handle contact lenses, or smoke in areas with likely exposure to blood or OPIM specimen collection rooms testing areas areas where specimens located Do not store food or beverages in refrigerators, freezers, coolers, shelves, cupboards where specimens are located

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Work Practice Controls Do not place hands into used sharps containers Use a brush or tongs to place broken glass or other sharp items into a dust pan for disposal Shearing, breaking, bending, re-capping of contaminated sharps is prohibited Do not remove needle from used tube holder after phlebotomy

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Biohazard Warning Labels Warning labels required on Containers of regulated waste Refrigerators and freezers containing blood or other potentially infectious material Containers used to store, transport, ship blood or other potentially infectious material Red bags or containers may be substituted for labels

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Specimens label with appropriate information wrap in material to prevent breakage place in plastic biohazard bag place paperwork in outside pouch of bag do not place specimens back into clean collection kits

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Hepatitis B Vaccine Any one with occupational exposure to blood or OPIM should be vaccinated recommended unless: antibody testing shows immunity employee has documentation of receipt of series employee has severe allergic reaction to vaccine components

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Hepatitis B Vaccine available within 10 working days of work start date if employee declines, must sign statement of declination employee may request the series later

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Hepatitis B Vaccine Effectiveness at least 90% of adults are immune after completing the three doses of vaccine since 1985, 90% reduction of number of HCW infected with HBV, largely due to vaccine

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Hepatitis B Vaccine administered by deep intramuscular injection 3 doses given: 1st two doses 1 month apart, last dose is given 5 months after second dose SLH will test antibody levels at 1-2 months after last dose to test for immunity non-responders will be-revaccinated

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What to do When an Exposure Incident Occurs 1) Clean the site. percutaneous injuries: wash with soap and water mucous membranes: rinse copiously with water 2) Report to your supervisor immediately. 3) Seek medical attention 4) Report to infection control at ) Complete an incident report and exposure incident report See complete instructions in your packet

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Transmission Based Precautions Contact Droplet Airborne Used in addition to standard precautions

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Contact precautions For infections transmitted by direct or indirect contact with an infected person or contaminated environment Wear gown, gloves for all contact with patient or potentially contaminated environment

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Droplet precautions For infections transmitted by close respiratory or mucous membrane contact with respiratory secretions Spatial separation of > 3 feet Use of surgical mask when within three feet of infected person

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Airborne precautions For infections carried over long distances (up to 25 feet) when suspended in the air In hospitals, airborne isolation with negative pressure are used Use of N-95 respirators is used when sharing air with infected person

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Airborne precautions N-95 respirators Must have respiratory protection plan Medical evaluations Fit testing Only those who are fit-tested may enter space of the infected person